Periventricular lesions correlate with cortical thinning in multiple sclerosis

Area of Science:

• Neurology
• Neuroimaging
• Neuroimmunology

Background:

• Cortical pathology in multiple sclerosis (MS) may be influenced by cerebrospinal fluid (CSF) factors.
• Investigating the relationship between periventricular lesions and cortical changes is crucial for understanding MS progression.

Purpose of the Study:

• To test the hypothesis that MS-related periventricular lesions correlate with cortical pathology.
• To assess the association between periventricular lesion load (PV-LL) and cortical mean thickness (CMT) in patients with clinically isolated syndrome (CIS) and relapsing-remitting MS (RRMS).

Main Methods:

• 160 patients (91 CIS, 69 RRMS) and 58 healthy controls (HCs) underwent 3.0T MRI.
• Periventricular lesion load (PV-LL) was quantified by segmenting lesions near dilated ventricles.
• Cortical thinning was measured as cortical mean thickness (CMT).

Main Results:

• CIS and RRMS patients showed significantly reduced CMT compared to HCs.
• Increased PV-LL significantly correlated with decreased CMT in RRMS patients (r = -0.295; p = 0.015), even after controlling for ventricular volume and total lesion load.
• No significant correlation was found between PV-LL and CMT in CIS patients (r = 0.032; p = 0.768).

Conclusions:

• The correlation between higher periventricular lesion burden and reduced cortical thickness supports the role of CSF-mediated factors in MS gray and white matter damage.
• These findings suggest a potential link between lesions near the ventricles and subpial cortical pathology in MS.